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Old 12-19-2012, 09:28 AM   #1
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Low ACTH normal cortisol should I be concerned?

I have been feeling bad and ran some lab work on my own. The morning ACTH was 4.0 and my cortisol was 13.7. Are these values off enough to address it with a MD? Other symptoms are lack of energy, lack of libido, sparse under arm hair growth, some muscle atropy, skin looks a bit darker,minor weight loss, slight nausea at times. The CBC blood work was normal. I am 52 and went through menopause about six years ago. I also have osteoporosis.

 
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Old 12-19-2012, 09:42 AM   #2
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Re: Low ACTH normal cortisol should I be concerned?

Could you post the normal ranges for your lab on the 2 tests you have? Your symptoms are consistent with possible adrenal insufficiency, and the best thing to do is see an endocrinologist first off and get a full pituitary panel done and possibly a cortisol stimulation test to check for Addison's. It is more sensitive than a regular serum cortisol and can pick up more subtle cases. If ACTH is low, it can be caused by a pituitary adenoma (small benign tumor) or pituitary insufficiency. I would go straight to an endo, bypassing GP if you can, unless your insurance requires referral.

 
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Old 12-19-2012, 10:00 AM   #3
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Re: Low ACTH normal cortisol should I be concerned?

According to lab Corp, the range for ACTH is 7.2-62.3 pg/ml (mine is 4.0) and the range for cortisol is 6.2-19.4 ug/do ( mine is 13.7). Thanks for your help!

 
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Old 12-19-2012, 10:48 AM   #4
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Re: Low ACTH normal cortisol should I be concerned?

In ordinary Addison's disease, ACTH is high to compensate for the low cortisol, so your results would suggest a pituitary origin, and that's where the workup should focus. You might consider seeing a specialist at your local university health clinic, where more heads are put together to solve problems like this. An MRI would probably be done after measuring all pituitary hormones. Keep us posted on your diagnostic progress, please. This should be treatable, and you should feel better once treatment stabilized!

 
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